It starts at traffic lights on the A177 at Shincliffe and heads eastwards along Mill Lane. Although on the periphery of the city, the road is almost entirely rural. It passes on a bridge over the A1(M), before a junction with a road which is unclassified but nonetheless well-used, as it cuts off a corner for people heading northwards. A few hundred yards later the B1198 becomes the A181, which TOTSOs northbound.

As might be guessed from the description, the B1198 primarily connects the A177 and A181, creating a route between east and west Durham avoiding the city centre. Its potential use in through routes across County Durham is reflected in its former designation as the A180, although it was downgraded following the improvement of roads in Durham City Centre in the 1970s.